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Seneca Valley Virus-001 and Cyclophosphamide in Treating Young Patients With Relapsed or Refractory Neuroblastoma, Rhabdomyosarcoma, or Rare Tumors With Neuroendocrine Features

Primary Purpose

Adrenocortical Carcinoma, Gastrointestinal Carcinoid Tumor, Kidney Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Seneca Valley virus-001
cyclophosphamide
laboratory biomarker analysis
pharmacological study
Sponsored by
Children's Oncology Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adrenocortical Carcinoma focused on measuring recurrent neuroblastoma, previously treated childhood rhabdomyosarcoma, recurrent childhood rhabdomyosarcoma, recurrent Wilms tumor and other childhood kidney tumors, recurrent retinoblastoma, recurrent adrenocortical carcinoma, recurrent gastrointestinal carcinoid tumor

Eligibility Criteria

3 Years - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of 1 of the following:

    • Neuroblastoma
    • Rhabdomyosarcoma
    • Wilms tumor
    • Retinoblastoma
    • Adrenocortical carcinoma
    • Carcinoid tumor
  • Relapsed or refractory disease
  • Measurable or evaluable disease
  • No known curative therapy or therapy proven to prolong survival with an acceptable quality of life
  • No known pulmonary tumors or metastases > 5 cm, as evaluated by chest CT scan
  • No clinically significant pulmonary and/or pericardial effusions (≥ grade 3), as evaluated by ECHO
  • No primary CNS tumors or known metastatic CNS disease involvement

PATIENT CHARACTERISTICS:

  • Karnofsky performance status (PS) 50-100% (for patients > 16 years of age)
  • Lansky PS 50-100% (for patients ≤ 16 years of age)
  • Peripheral ANC ≥ 1,000/mm^3
  • Platelet count ≥ 100,000/mm^3 (transfusion independent, defined as no platelet transfusions within a 7-day period before study enrollment)
  • Hemoglobin ≥ 8.0 g/dL (RBC transfusions allowed)
  • Creatine clearance or radioisotope GFR ≥ 70 mL/min OR serum creatinine based on age/gender as follows:

    • ≤ 0.8 mg/dL (for patients 3 to 5 years of age)
    • ≤ 1.0 mg/dL (for patients 6 to 9 years of age)
    • ≤ 1.2 mg/dL (for patients 10 to 12 years of age)
    • ≤ 1.4 mg/dL (for female patients ≥ 13 years of age)
    • ≤ 1.5 mg/dL (for male patients 13 to 15 years of age)
    • ≤ 1.7 mg/dL (for male patients ≥ 16 years of age)
  • Bilirubin (sum of conjugated and unconjugated) ≤ 1.5 times upper limit of normal (ULN)
  • SGPT ≤ 110 U/L (for the purpose of this study, the ULN for SGPT is 45 U/L)
  • Serum albumin ≥ 2 g/dL
  • Oxygen saturation > 92% on room air
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to comply with the safety monitoring requirements of the study, in the opinion of the investigator
  • Completely toilet trained
  • No chronic diarrhea or urinary incontinence during the day or night, , and no in-dwellling urinary catheters
  • No uncontrolled infection
  • No known pregnant member of the household

PRIOR CONCURRENT THERAPY:

  • Fully recovered from the acute toxic effects of all prior anti-cancer chemotherapy
  • At least 6 months since prior total-body irradiation (TBI), craniospinal radiotherapy, or radiotherapy to ≥ 50% of the pelvis
  • At least 3 months since prior stem cell transplantation or rescue (without TBI)

    • No evidence of active graft-vs-host disease
  • At least 6 weeks since other prior substantial bone marrow radiotherapy or treatment with therapeutic doses of MIBG
  • More than 3 weeks since prior myelosuppressive chemotherapy
  • At least 2 weeks since prior local palliative radiotherapy (small port)
  • More than 7 days since prior growth factor(s) that support platelet or white blood cell number or function
  • At least 7 days since prior biologic agents
  • At least 3 half-lives since prior monoclonal antibodies
  • More than 7 days since prior viral immunizations, including influenza
  • At least 42 days since the completion of any type of immunotherapy, e.g., tumor vaccines
  • No other viral immunizations after enrolling on study until 28 days after their last planned Seneca Valley virus-001 infusion or until documented viral clearance, whichever is longest
  • Concurrent corticosteroids allowed provided the patient has been on a stable or decreasing dose for the past 7 days
  • No other concurrent investigational drugs
  • No other concurrent anticancer agents (e.g., chemotherapy, radiotherapy, immunotherapy, or biologic therapy)
  • Prior treatment with Seneca Valley virus-001 is not allowed

Sites / Locations

  • UAB Comprehensive Cancer Center
  • Children's Hospital of Orange County
  • UCSF Helen Diller Family Comprehensive Cancer Center
  • Children's National Medical Center
  • Children's Memorial Hospital - Chicago
  • Riley's Children Cancer Center at Riley Hospital for Children
  • Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute
  • C.S. Mott Children's Hospital at University of Michigan Medical Center
  • Masonic Cancer Center at University of Minnesota
  • Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
  • Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
  • Cincinnati Children's Hospital Medical Center
  • Children's Hospital of Pittsburgh of UPMC
  • St. Jude Children's Research Hospital
  • Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
  • Baylor University Medical Center - Houston
  • Children's Hospital and Regional Medical Center - Seattle
  • Midwest Children's Cancer Center at Children's Hospital of Wisconsin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (NTX-010)

Arm Description

Outcomes

Primary Outcome Measures

Safety and tolerability
Recommended phase II dose of Seneca Valley virus-001 (NTX-010)

Secondary Outcome Measures

Tumor response
Viral titers in blood and stool
Development of antibodies to NTX-010

Full Information

First Posted
January 13, 2010
Last Updated
January 29, 2014
Sponsor
Children's Oncology Group
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT01048892
Brief Title
Seneca Valley Virus-001 and Cyclophosphamide in Treating Young Patients With Relapsed or Refractory Neuroblastoma, Rhabdomyosarcoma, or Rare Tumors With Neuroendocrine Features
Official Title
A Phase 1 Dose Escalation Study of Seneca Valley Virus (NTX-010), A Replication-Competent Picornavirus, in Relapsed/Refractory Pediatric Patients With Neuroblastoma, Rhabdomyosarcoma, or Rare Tumors With Neuroendocrine Features
Study Type
Interventional

2. Study Status

Record Verification Date
January 2014
Overall Recruitment Status
Completed
Study Start Date
September 2009 (undefined)
Primary Completion Date
June 2013 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Children's Oncology Group
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Seneca Valley virus-001 may be able to kill certain kinds of tumor cells without damaging normal cells. Adding low dose cyclophosphamide (in part B of study) may help to kill even more tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of Seneca Valley virus-001 in treating young patients with relapsed or refractory neuroblastoma, rhabdomyosarcoma, or rare tumors with neuroendocrine features.
Detailed Description
OBJECTIVES: Primary To estimate the maximum-tolerated dose and/or recommended phase II dose of Seneca Valley virus-001 (NTX-010) when administered as a single infusion to pediatric patients with relapsed or refractory neuroblastoma, rhabdomyosarcoma, or rare tumors with neuroendocrine features (Wilms tumor, retinoblastoma, adrenocortical carcinoma, or carcinoid tumors). (Part A [completed]) To confirm that there is viral replication in these patients following NTX-010 administration. (Part A [completed]) To define and describe the toxicities of NTX-010 when administered on this schedule. (Part A [completed]) To determine whether the number of regulatory T cells (as measured by flow cytometry) can effectively be reduced following administration of NTX-010 plus low-dose metronomic and intravenous cyclophosphamide. (Part B) To characterize the pharmacokinetics (time course of viral clearance) following NTX-010 administration in these patients. Secondary To preliminarily define the antitumor activity of NTX-010 within the confines of a phase I study. (Part A [completed]) To evaluate the development of neutralizing antibodies to NTX-010 following IV administration of NTX-010. (Part A [completed]) To evaluate development of neutralizing antibodies to NTX-010 following the combination of NTX-010 and cyclophosphamide. (Part B) To investigate the presence and permissivity of occult circulating tumor cells prior to and after the initial intravenous administration of NTX-010. OUTLINE: This is a multicenter study. Part A (completed): Patients receive Seneca Valley virus-001 (NTX-010) IV over 1 hour on day 1. Part B: Patients receive cyclophosphamide IV orally (PO) on days 1-14 and NTX-010 IV over 1 hour on day 8. In the absence of disease progression or unacceptable toxicity, patients then receive cyclophosphamide orally (PO) on days 22-35, plus cyclophosphamide IV over 1 hour and NTX-010 IV over 1 hour on day 29. Tumor tissue samples are collected at baseline for biomarker studies. Blood and stool samples are collected periodically for neutralizing antibody and viral clearance studies. Additional blood samples may also be collected for the presence and permissivity of occult tumor cells. After completion of study treatment, patients are followed up periodically for up to 1 year.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adrenocortical Carcinoma, Gastrointestinal Carcinoid Tumor, Kidney Cancer, Neuroblastoma, Retinoblastoma, Sarcoma
Keywords
recurrent neuroblastoma, previously treated childhood rhabdomyosarcoma, recurrent childhood rhabdomyosarcoma, recurrent Wilms tumor and other childhood kidney tumors, recurrent retinoblastoma, recurrent adrenocortical carcinoma, recurrent gastrointestinal carcinoid tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (NTX-010)
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Seneca Valley virus-001
Intervention Type
Drug
Intervention Name(s)
cyclophosphamide
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Type
Other
Intervention Name(s)
pharmacological study
Primary Outcome Measure Information:
Title
Safety and tolerability
Time Frame
12 months post-documented viral clearance
Title
Recommended phase II dose of Seneca Valley virus-001 (NTX-010)
Time Frame
56 days
Secondary Outcome Measure Information:
Title
Tumor response
Time Frame
Up to 12 months post documented viral clearance
Title
Viral titers in blood and stool
Time Frame
Up to 56 days post treatment
Title
Development of antibodies to NTX-010
Time Frame
Up to 4 weeks post treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed diagnosis of 1 of the following: Neuroblastoma Rhabdomyosarcoma Wilms tumor Retinoblastoma Adrenocortical carcinoma Carcinoid tumor Relapsed or refractory disease Measurable or evaluable disease No known curative therapy or therapy proven to prolong survival with an acceptable quality of life No known pulmonary tumors or metastases > 5 cm, as evaluated by chest CT scan No clinically significant pulmonary and/or pericardial effusions (≥ grade 3), as evaluated by ECHO No primary CNS tumors or known metastatic CNS disease involvement PATIENT CHARACTERISTICS: Karnofsky performance status (PS) 50-100% (for patients > 16 years of age) Lansky PS 50-100% (for patients ≤ 16 years of age) Peripheral ANC ≥ 1,000/mm^3 Platelet count ≥ 100,000/mm^3 (transfusion independent, defined as no platelet transfusions within a 7-day period before study enrollment) Hemoglobin ≥ 8.0 g/dL (RBC transfusions allowed) Creatine clearance or radioisotope GFR ≥ 70 mL/min OR serum creatinine based on age/gender as follows: ≤ 0.8 mg/dL (for patients 3 to 5 years of age) ≤ 1.0 mg/dL (for patients 6 to 9 years of age) ≤ 1.2 mg/dL (for patients 10 to 12 years of age) ≤ 1.4 mg/dL (for female patients ≥ 13 years of age) ≤ 1.5 mg/dL (for male patients 13 to 15 years of age) ≤ 1.7 mg/dL (for male patients ≥ 16 years of age) Bilirubin (sum of conjugated and unconjugated) ≤ 1.5 times upper limit of normal (ULN) SGPT ≤ 110 U/L (for the purpose of this study, the ULN for SGPT is 45 U/L) Serum albumin ≥ 2 g/dL Oxygen saturation > 92% on room air Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Able to comply with the safety monitoring requirements of the study, in the opinion of the investigator Completely toilet trained No chronic diarrhea or urinary incontinence during the day or night, , and no in-dwellling urinary catheters No uncontrolled infection No known pregnant member of the household PRIOR CONCURRENT THERAPY: Fully recovered from the acute toxic effects of all prior anti-cancer chemotherapy At least 6 months since prior total-body irradiation (TBI), craniospinal radiotherapy, or radiotherapy to ≥ 50% of the pelvis At least 3 months since prior stem cell transplantation or rescue (without TBI) No evidence of active graft-vs-host disease At least 6 weeks since other prior substantial bone marrow radiotherapy or treatment with therapeutic doses of MIBG More than 3 weeks since prior myelosuppressive chemotherapy At least 2 weeks since prior local palliative radiotherapy (small port) More than 7 days since prior growth factor(s) that support platelet or white blood cell number or function At least 7 days since prior biologic agents At least 3 half-lives since prior monoclonal antibodies More than 7 days since prior viral immunizations, including influenza At least 42 days since the completion of any type of immunotherapy, e.g., tumor vaccines No other viral immunizations after enrolling on study until 28 days after their last planned Seneca Valley virus-001 infusion or until documented viral clearance, whichever is longest Concurrent corticosteroids allowed provided the patient has been on a stable or decreasing dose for the past 7 days No other concurrent investigational drugs No other concurrent anticancer agents (e.g., chemotherapy, radiotherapy, immunotherapy, or biologic therapy) Prior treatment with Seneca Valley virus-001 is not allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael J. Burke, MD
Organizational Affiliation
Masonic Cancer Center, University of Minnesota
Official's Role
Study Chair
Facility Information:
Facility Name
UAB Comprehensive Cancer Center
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Children's Hospital of Orange County
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
UCSF Helen Diller Family Comprehensive Cancer Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Children's National Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010-2970
Country
United States
Facility Name
Children's Memorial Hospital - Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Riley's Children Cancer Center at Riley Hospital for Children
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
2115
Country
United States
Facility Name
C.S. Mott Children's Hospital at University of Michigan Medical Center
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109-0286
Country
United States
Facility Name
Masonic Cancer Center at University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229-3039
Country
United States
Facility Name
Children's Hospital of Pittsburgh of UPMC
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
St. Jude Children's Research Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States
Facility Name
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Baylor University Medical Center - Houston
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-2399
Country
United States
Facility Name
Children's Hospital and Regional Medical Center - Seattle
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Midwest Children's Cancer Center at Children's Hospital of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Seneca Valley Virus-001 and Cyclophosphamide in Treating Young Patients With Relapsed or Refractory Neuroblastoma, Rhabdomyosarcoma, or Rare Tumors With Neuroendocrine Features

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